LEARNING FROM THE IMPLEMENTATION OF INTEGRATED COMMUNITY-BASED PROGRAMS FOR OLDER ADULTS WITH HIGHER NEEDS

Abstract Three demonstration projects of integrated community-based programs for older adults with higher needs were implemented in British Columbia over 2020 to 2023: 1) Social Prescribing (SP, n=19 programs), 2) Therapeutic Activation Programs for Seniors (TAPS, n=15 programs), and 3) Family and Friend Caregiver Groups (FFCG, n=16 programs). This presentation reports on findings on the programs’ design and implementation based on data collected via interviews and surveys of program staff. Since inception, the total number of unique participants programs have served is 1,078 for TAPS, 1,900 for FFCG, and 1,397 for SP. The majority of clients have been long-term clients receiving services for 3 or more months. Due to the COVID-19 pandemic, 80% of programs reported they had shifted their focus during their first year of operations in response to emergent pandemic needs, thus impacting their start-up and initial intake of clients. The flexibility provided to programs to pivot to offering needed supports during the height of the pandemic was considered an important success. Across all types of programs, client who were socially isolated or lacked social supports were perceived as one of the groups who benefited the most from the programs. Programs reported that their relationships with community-based organizations, primary care networks, and home and community care were strengthened and over three-quarters had formed at least three new partnerships. A variety of facilitating (e.g., leveraging pre-existing relationships) and limiting factors (e.g., awareness of programs and obtaining referrals) were identified that have affected the success of program implementation.

To age-in-place, older adults need to access their community.As most older adults live in suburban/rural areas, driving is the primary and preferred means of mobility.While recent research has shown that drivers in the seventies have fewer crashes than middle-aged drivers, it is likely due to less exposure.However, it demonstrates that driving decisions need to be based on function, not age.Moreover, with the aging population and increase numbers of older adults with cognitive impairment and/or slowed processing speed, other strategies are needed to preserve and lengthen the driving lifetime.While efforts for developing alternative transportation options are working in some places, rural areas lack the infrastructure and potential for public transportation or volunteer programs beyond medical necessity.This presentation will present some roadway engineering proven countermeasures and community strategies that can protect and benefit aging drivers so they can drive longer while reducing crash risk.Stepping outside the typical gerontological community, this presenter became a contributing member of their state's highway safety five-year plan.As an older driver advocate, I was successful in achieving older adults as an "emphasis" area in the present plan.For the next five-year plan, researching engineering solutions was deemed essential to advocate for specific strategies that protect both aging drivers and pedestrians.Since every state is required have a five-year plan for highway safety to receive federal funding, the presenter will outline successful strategies to participate in innovative ways for improving safety such as influencing engineering and department of motor vehicles partners.

ASSESSING THE NEEDS OF OLDER ADULTS IN RURAL WEST TEXAS
Suzie Macaluso, and Julia Free, Abilene Christian University, Abilene, Texas, United States With 1 in 5 adults over the age of 65 living in rural areas, understanding their unique concerns and needs becomes increasingly important.This study was carried out in partnership with the West Central Texas Area Agency on Aging (WCT AAA) to identify the top concerns of older adults in rural West Texas.The survey was conducted in person at four locations across the region served by the WCT AAA.A total of 183 respondents completed the survey and their responses to the question "what are the biggest issues facing older adults today" along with demographic information were collected.Participants were between the ages of 56 and 95 years old with a mean age of 76 years old.60% of the participants were female and 40% were male.Respondents were predominantly White, 80%, with 16% Hispanic or Latino, and 3% Black or African American.The most common concern among respondents was physical health and well being with the increasing cost of living being the second most frequent response.Additionally, residents from more rural counties reported social interaction as more important than either health or cost of living.These findings highlight the need for targeted interventions to address the concerns of older adults in rural areas, particularly related to healthcare access and social isolation.Strategies such as telemedicine and community-based programs to address transportation and social isolation may be particularly effective in addressing these concerns.

EFFICACY OF A HOME-BASED EXERCISE PROGRAM "SENIOR FIT" FOR OLDER ADULTS DURING THE COVID-19 PANDEMIC
Kate Hyun, Kathy Lee, Vina Lervisit, Kimberly Vanhoose, Xiangli Gu, Troyee Saha, Boni Jobaidul, and Angela Liegey-Dougall, University of Texas at Arlington, Arlington, Texas, United States With elevated awareness and concerns of infectious diseases such as COVID-19, the importance of overall health and wellbeing has been highlighted.More than 25% of older adults, including individuals with underlying health conditions, did not maintain the same intensity of physical activity during the pandemic.The purpose of this study was to examine the efficacy of a home-based exercise program, Senior Fit, for older adults during the COVID-19 pandemic.Senior Fit employs conventional behavior boosting approaches to promote physical activities and reduce sedentary behaviors.Older adults (N = 58) participated in the program and completed a weekly set of exercises for eight weeks.We conducted in-depth, individual interviews with 53 participants and identified four themes related to the program: (1) positive perceptions on the structure, (2) individual variances in their overall experience, (3) perceived benefits, and (4) feedback on human interactions.The participants appreciated the structure, especially following schedules provided and using paper forms to track their activities.However, some complained the program was too easy while others thought the program was too challenging.Overall, the participants discussed physical benefits (e.g., weight loss, established exercise habits) and emotional benefits (e.g., better mood, motivations).They suggested the importance of creating an inclusive and interactive environment.Many discussed the importance of the interactions with the research team as well as other participants to stay motivated in the program during the pandemic.These findings highlighted the need to involve participant stakeholders in the development of programs to increase physical activity in older adults.

LEARNING FROM THE IMPLEMENTATION OF INTEGRATED COMMUNITY-BASED PROGRAMS FOR OLDER ADULTS WITH HIGHER NEEDS
Bobbi Symes, and Kahir Lalji, United Way British Columbia, Burnaby, British Columbia, Canada Three demonstration projects of integrated communitybased programs for older adults with higher needs were implemented in British Columbia over 2020 to 2023: 1) Social Prescribing (SP, n=19 programs), 2) Therapeutic Activation Programs for Seniors (TAPS, n=15 programs), and 3) Family and Friend Caregiver Groups (FFCG, n=16 programs).This presentation reports on findings on the programs' design and implementation based on data collected via interviews and surveys of program staff.Since inception, the total number of unique participants programs have served is 1,078 for TAPS, 1,900 for FFCG, and 1,397 for SP.The majority of clients have been long-term clients receiving services for 3 or more months.Due to the COVID-19 pandemic, 80% of programs reported they had shifted their focus during their first year of operations in response to emergent pandemic needs, thus impacting their start-up and initial intake of clients.The flexibility provided to programs to pivot to offering needed supports during the height of the pandemic was considered an important success.Across all types of programs, client who were socially isolated or lacked social supports were perceived as one of the groups who benefited the most from the programs.Programs reported that their relationships with community-based organizations, primary care networks, and home and community care were strengthened and over three-quarters had formed at least three new partnerships.A variety of facilitating (e.g., leveraging preexisting relationships) and limiting factors (e.g., awareness of programs and obtaining referrals) were identified that have affected the success of program implementation.

WHEN POLICY INTENTIONS GO ASTRAY: THE DEPLOYMENT OF HOME CARE AND HOME SUPPORT MARKET TOOLS IN FRANCE AND QUEBEC.
Patrik Marier 1 , and Loïc Trabut 2 , 1. Concordia University,Montreal,Quebec,Canada,2. INED,Paris,France Using Gingrich's (2011) typology of welfare markets, this contribution studies the selection and enactment of market tools in two different jurisdictions (France and Quebec).Quebec represents a classic example of a managed market with regional health authorities (CISSS/CIUSSS) seeking the lower the cost of long-term care by contracting services to community groups and the private sector.These contractual agents have gradually replaced health and social care professionals within the public system.France has opted to enact a consumer driven market with the introduction of the allocation personnalisée d'autonomie (APA) which provides cash benefits to eligible older adults who can then select the provider of their choice.Both of these market reforms are compared and analyzed across three types of territories : rural (Finistère and Bas-St-Laurent), urban (Paris and Montreal), and in industrial decline (Somme and Mauricie).Despite operating within highly differentiated long-term care policy frameworks and market tools, both jurisdictions face similar difficulties in the enactment of market mechanisms.For instance, rural territories fail to generate sufficient providers to develop a market where a regional health authority (Quebec) or older adults (France) can actually select a provider and negotiate terms of service.Public authorities must then intervene to generate market-like conditions.Regardless of the jurisdiction, the conceptualization of market mechanism has clearly an urban setting in mind making them ill-suited for other environment and there is gradual movement towards the development of austerity market where individuals are forced to seek alternatives beyond the market tools deployed by governments.

DESIGN NEEDS AND PERCEPTIONS OF OLDER ADULTS REGARDING SHARED-USE AUTOMATED VEHICLES
Justin Lam 1 , Tarryn O'Rourke 2 , Caitlin Bowman 2 , and Clive D'Souza 2 , 1. Carnegie Mellon University, Pittsburgh, Pennsylvania, United States, 2. University of Pittsburgh, Pittsburgh, Pennsylvania, United States Many communities struggle to provide safe, accessible, and reliable transportation services for older adults due to high demand, rising costs, driver shortages, and other evolving challenges.Innovative transportation solutions are needed to support the current and future populations of older adults.Low-speed, shared-use, driverless shuttles present an exciting development in automated vehicle (AV) technology with potential to meet mobility needs of older adults in their community.Understanding older adults' perceptions about and willingness to consider using these emerging modes of transportation is vital to realizing the full potential of these technologies.This presentation summarizes an in-person study conducted with 12 older (average: 66 +/-4 years of age, range: 60 to 80 years) and 10 younger (average: 44 +/-11 years) adults that evaluated a stationary, proof-of-concept shared-use AV retrofitted with accessibility features.We will present findings on perceptions regarding accessibility, safety, and willingness to use driverless AVs along with human factors design recommendations.While questionnaire-based studies have been the dominant approach to understanding older adults' perceptions about shared-use AVs, in-person evaluations even with prototype AVs as described here, provide opportunities to identify goals, needs and preferences of older adults concerning usability and safety in early design stages, and through hands-on exploration help older adults develop good mental models, i.e., understand AV capabilities and limitations, towards building trust and acceptance for these emerging modes of transportation.Research and policy implications will be discussed towards enabling emerging driverless shared-use AV technologies that support safe and independent community mobility for older adults.

EXPERIENCES OF TECHNOLOGY USE BY OLDER ADULTS DURING COVID-19
Tina Kilaberia 1 , Yuanyuan Hu 1 , Edward Ratner 2 , and Janice Bell 3 , 1. New York University,New York City,New York,United States,2. Minneapolis VA Health Care System,Minneapolis,Minnesota,United States,3. University of California,Davis,Davis,California,United States Computer and communications technology use expanded during the COVID-19 pandemic, but little is known about how this affected older people.Using the Unified Theory of Acceptance and Use of Technology questionnaire and qualitative interviews, we examined 18 older adults' technology use during COVID-19 across two subgroups of nine older adults each: those scoring above ("high") and those scoring below ("low") the median (4.09).Overall, older adults scored fairly high (mean 4.0; SD=0.5; range 3.1-4.8across 16 items on a scale of 1 to 5).In each group of nine older adults, four (44%) described technology as being helpful during the pandemic.Among high scoring older adults, 100% utilized technology to order either groceries or household items and six (67%) used either telehealth or online health information system (i.e., MyChart) to communicate with health services providers, compared to three (33%) and four (44%) within the low scoring group.No one in the high scoring group